Inspection on 10/04/08 for Galtee More Nursing Home

This inspection was carried out on 10th April 2008.

CSCI found this care home to be providing an Poor service.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Galtee More Nursing Home 22/09/08

Galtee More Nursing Home 16/04/07

Galtee More Nursing Home 07/12/05

Galtee More Nursing Home 21/06/05

Galtee More Nursing Home 21/04/05

Galtee More Nursing Home 13/01/05

Galtee More Nursing Home 18/08/04

Galtee More Nursing Home 24/03/04

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Galtee More Nursing Home 164 Doncaster Road Barnsley South Yorkshire S70 1UD Lead Inspector Mrs Sue Stephens Key Unannounced Inspection 10th April 2008 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Galtee More Nursing Home DS0000006480.V364081.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Galtee More Nursing Home DS0000006480.V364081.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Galtee More Nursing Home Address 164 Doncaster Road Barnsley South Yorkshire S70 1UD Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01226 733977 None None Dr Gulzar Khan Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places Galtee More Nursing Home DS0000006480.V364081.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Persons accommodated shall be aged 60 years and above. Date of last inspection 16th April 2007 Brief Description of the Service: Galtee More is a 28-bed home for older people; it provides both nursing and personal care. The home is in a residential area on the outskirts of Barnsley town centre, where there is good access to public services. There is a bus route, a variety of shops, health centre, post office, pubs, and church near by. The home has disabled access and a passenger lift to all levels. There are eighteen single and five double rooms, two lounges and a dining room. There is a garden and car parking is available at the side of the building. The information about the homes fees and charges was provided on 21.04.07. Nursing care Residential care Low band £373.50 £335.00 Medium band £420.50 High Band £472.50 There is also a NHS Nursing Care Component Additional charges Chiropody, hairdressing and personal newspapers. Prospective residents and their families can get information about Galtee More by contacting the manager. The home will also provide a copy of the statement of purpose and the latest inspection report. Galtee More Nursing Home DS0000006480.V364081.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 0 star. This means the people who use this service experience poor quality outcomes. This visit was unannounced. It took place between 9:30 am and 5:00 pm on 10th April 2008. In the report we make reference to “us” and “we”. When we do this we are referring to the inspector and the Commission for Social Care Inspection. The manager, Sue Dooler assisted us during our visit. We looked at other information before visiting Galtee More Nursing Home. This included evidence from the last key inspection, evidence from our random inspection, and the services Annual Quality Assurance Assessment (AQAA). An AQAA is information the commission ask service’s to provide, about once a year. This shows us how the provider thinks the home is performing. On the random inspection we followed up concerns reported to us. We have included our findings in this report. We checked some areas of the premises and checked a sample of the home’s records. These included three people’s care plans and staff files. The visit included talking to people who live there, three relatives and three members of staff. We would like to thank the people who use the service, relatives, staff, and managers for their assistance in this inspection. What the service does well: People tell us this is a warm friendly home. It has a relaxed atmosphere and people tell us they are very fond of members of the staff team. Nurses assess people’s needs to make sure staff that the home can support them and meet their individual needs. Relatives told us they get good information and nurses and staff keep them informed about their family members welfare. People told us staff understand their needs and they are satisfied with their care and support. People have care plans that record their health and personal care needs. Galtee More Nursing Home DS0000006480.V364081.R01.S.doc Version 5.2 Page 6 Relatives told us their family members get good access to health care services. Nurses manage the medication systems in a safe way. People told us they enjoy sitting in the conservatory, they have tea, visitors and social gatherings there. People, or their relatives, manage their monies and finances; this helps people maintain their own independence. People said they are satisfied with their meals; and they are happy with the arrangements at mealtimes. Which are breakfast and lunch in the dining rooms, and tea and supper in the conservatory and lounge. People can raise concerns and complaints and the staff and manager take action to address these. People told us they were liked their surroundings and were happy with their bedrooms. People personalised their bedrooms to their own tastes. Staff have had training, for example they have had, safeguarding adults, mental capacity, and safe working practice (health and safety) training. And most staff had a National Vocational qualification in care. This helps the staff team give people safe and consistent care and support. People, and their relatives told us they were happy with the staff team. Our findings from the random inspection we carried out on 3 October 2007: When we visited we found the home was warm and the atmosphere was friendly and relaxed. People were having their tea in a sociable and comfortable way. Staff were attentive to people and people said they were happy. A group of people, who were sat together, told me “you have nothing to worry about, everything is fine here”. What has improved since the last inspection? The nurses have continued to improve the care plans so that they have better information about people’s health and personal care. The manager has improved the recruitment systems so that the home can make sure it employs the right staff to support people. The manager confirmed that all staff now have the appropriate Criminal Record Bureau Check. Nurses have improved their medication practices so that they are safer. Galtee More Nursing Home DS0000006480.V364081.R01.S.doc Version 5.2 Page 7 There are some improvements to the home, such as redecoration to communal areas and bedrooms. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Galtee More Nursing Home DS0000006480.V364081.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Galtee More Nursing Home DS0000006480.V364081.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3. The home had no referrals for intermediate care. People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. People who live at the home have their needs assessed, and staff review this so that they can continue to meet peoples changing needs. EVIDENCE: Two relatives told us they felt well informed. One person told us they came to look around and chose Galtee More with her families help. Relatives told us they were well informed, they told us they had news-sheets telling them about the homes’ developments, and one relative said, “The manager or staff always phone me”. People said they were satisfied that staff understood and could meet their needs. Galtee More Nursing Home DS0000006480.V364081.R01.S.doc Version 5.2 Page 10 People had local authority assessments and the manager and qualified staff looked at these before meeting individuals and deciding if Galtee More could offer them care. Before agreeing that someone could come to Galtee More the manager said they carried out their own assessment. The homes assessment tool is basic but adequate. The home could improve their assessments so that people are more involved with them. This will help people give better information about their lives, their aspirations and needs. The assessments considered people’s diverse needs. This helps the home understand and meet peoples’ different needs and aspirations, for example their disability, religion or culture. Galtee More Nursing Home DS0000006480.V364081.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. People who use the service experience adequate quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. People get health and personal care based on their individual needs. However, staff need to improve practices to make sure people receive care and accommodation with respect and dignity. EVIDENCE: People said they were happy with the care they received. And relatives told us the nurses invited them to look at and give their opinion about their family members care plans. One person said in a positive manner “Yes staff look after me well, I’ll tell my daughter if they don’t” The relatives told us they felt satisfied that their family members get good access to health care services. Both relatives said nurses were good at giving them information. Galtee More Nursing Home DS0000006480.V364081.R01.S.doc Version 5.2 Page 12 The nurses and managers had continued to improve the plans since our last key and random inspections. The plans were satisfactory, however the manager and nurses could do more work on these to produce them in a more person centred way. This would help people keep more in control of their care, preferences, and independence. The Records we checked, about people’s health care needs, were satisfactory. Relatives said their family members got good support from nurses who administered and reviewed their medication. Both relatives told us they have no concerns. We watched part of a medication round and looked at some records and the storage systems. Practices, storage and records have improved since our last key and random inspections. The medication systems are in good order. The inspector spent time observing care practices. The staff spoke to people in a dignified manner, the staff were positive and professional in their approach. People and staff had a good rapport with each other. When people asked to be left alone, in their rooms, staff adhered to this and respected their privacy. We noticed staff made discreet checks to make sure people were alright. This was good practice and is an example of the caring approaches we saw staff do. We saw some practices that do not promote people’s dignity and respect. For example: We saw continence pads on display, where people and their visitors could easily see them Staff had left someone’s old slippers and shoes in a bathroom, even though the person was no longer at the home We found an open cupboard with a range of used toiletries; it was not possible to identify who they belonged to. This put people at risk of using communal toiletries Most people had old wooden commodes in their rooms, this included people who did not need commodes One member of staff fed two people at the same time, this was poor practice because it was undignified and did not treat people as individuals. It made mealtimes more of a task rather than a sociable and personal experience for the individual. Our findings from the random inspection we carried out on 3 October 2007: We called at the home at 5pm. There were a number of people already in dressing gowns and nightwear. However, when we spoke to people they said they were happy about this. One person said they preferred this because they Galtee More Nursing Home DS0000006480.V364081.R01.S.doc Version 5.2 Page 13 don’t like getting dressed after a bath, another person said they liked to retire very early so it suited them; and another person said they were more comfortable in the evening wearing night wear. Visiting relatives also confirmed that they felt staff did follow people’s preferred routines. Although a number of people were in their nightwear people looked clean, dignified and relaxed. We checked the records relating to the last weight checks. Staff had done this on a piece of scrap paper and they had not transferred the information into peoples care plans. This put the records at risk of getting lost or, because the paper was scrap and untidy, staff could misread the information when putting it into people’s care plans. To keep people safe we advised the nurse to make sure staff always use the correct form to record people’s weights. On our key inspection dated 10 April 2008, we found people had suitable weight records. Galtee More Nursing Home DS0000006480.V364081.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. People who use the service experience adequate quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. People do not get a lot of choice to do different activities. People get good meals and nutrition; however, some practices do not respect some people’s dignity. EVIDENCE: One person said about the way they spend their day at the home “I like to sit with my friends, we have tea in the conservatory, and I like that”. A relative said the home does organise some trips, and they often have raffles. On our last key inspection we made recommendations because some people were not happy with the amount and choice of activities they had. This time we did not speak to people who had an opinion about this. We asked a number of staff; they said giving people a range of activities was difficult because some people were quite ill or had complex medical needs. Galtee More Nursing Home DS0000006480.V364081.R01.S.doc Version 5.2 Page 15 Staff also told us staffing levels affected how much they could do with people. For example, they talked about how they make sure they meet people’s comfort, personal and health care needs first. A relative told us more activities would be better, and they said they felt their family member would join in. People told us that in warm weather they liked to sit on the front where they could chat to passing people. We have carried the recommendations forward and we will check these again in the future. People at the home and relatives agreed that visiting times were suitable and that staff made visitors welcome. A notice on the front door states the home does not accept visitors at mealtimes, but states if people find this inconvenient they can see the manager and agree visiting arrangements. The manager confirmed that all people (or their chosen relative or advocate) managed their own finance. People said they are satisfied with their meals. They said, “The meals are ok here” “I have nothing to complain about” “The food is good, I’d like more variety, but not everyone else does. I’d like the occasional curry and things like that”. The inspector observed lunchtime. The atmosphere was relaxed and sociable. We noted the quality and quantity of cutlery and crockery had improved since we last visited. We noted that one staff member sat between two people, who needed assistance to eat, and spoon-fed them alternatively. This has a very poor impact on their dignity. We brought this to the manager’s attention on the day and asked that all staff stop this practice. Kitchen staff prepare soft diets by liquidising the items of the meal all together. This does not respect people’s preference, enjoyment of tastes, or their dignity. We advised the kitchen staff to improve this practice by liquidising items separate. For example they can liquidise the meat and gravy and serve with mashed potatoes and separate mash vegetables. Some people sit in the dining area for a long time before staff can serve their meals. The manager is aware of this; it is because most people depended on waiting for the lift so they can access the dining room. At teatime people eat in the lounge, this is a relaxed routine and people told us they liked to do this. Galtee More Nursing Home DS0000006480.V364081.R01.S.doc Version 5.2 Page 16 Some people have their meals in their own room because they preferred it. Galtee More Nursing Home DS0000006480.V364081.R01.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. People can give their opinion about their care; managers and staff listen and take action. People get support from a service that understands how to protect them from abuse. EVIDENCE: People told us they could complain or raise concerns. They said they could tell the staff or the manager. And relatives told us they understand the complaints procedure or that they feel confident they can go to the manager and she will take action. Relatives said, “I think my (relative) is safe here, you can tell by the way staff speak to her” “We can ask questions, and staff will sort it out”. The manager has a good a system for staff to access safeguarding training and guidance. This informs staff how to identify if someone may be at risk of harm or abuse; and what action they must take to keep people safe. The manager told us she had completed the ‘Train the Trainers’ course for Safeguarding Adults and she had brought staff up-to-date with safeguarding training. The manager demonstrated to us that she has good knowledge and she has a good resource of up-to-date information for staff to refer to. Galtee More Nursing Home DS0000006480.V364081.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 23 and 26. People who use the service experience adequate quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. People live in a homely environment. However the bating facilities are inadequate. We have also made requirements about the homes environment and how it must improve people’s dignity and safety under standards 10 and 38. EVIDENCE: Relatives told us about the homes environment, “Every time I have been in Mum’s room it has been lovely” “Mum likes the conservatory” “It has a homely atmosphere here” “Pleasant” “It is quite nice but some places need better décor” “It needs better decoration and new furnishings” Galtee More Nursing Home DS0000006480.V364081.R01.S.doc Version 5.2 Page 19 People told us they were, in the main, happy with the homes environment. And they told us they were happy with their bedrooms. We noted people had personalised bedrooms. This means they furnish them and use them the way they wish. We have seen some improvements to the homes décor and maintenance over the past couple of inspections, and the manager has worked well towards meeting previous requirements. The conservatory, entrance, and several bedrooms have new décor. The home did not have suitable bathrooms and washing facilities. Two bathrooms have been out of order for some time, for example one bathroom has a toilet dismantled. This means that there are only two bathrooms for the whole building (28 people). The National Minimum Standards for older people state that homes should have a minimum of one assisted bath to 8 people. However, the remaining two bathrooms have hoists that are out-of order. This means people are unable to bathe. Until the home repairs the hoists people must wash in their own rooms. The water supply to some rooms is poor and staff have to carry bowls of hot water into people’s bedrooms. This is poor practice, and does not respect people’s dignity and rights to adequate bathing facilities. The dryer was still out of order. This was raised as a concern on the Random inspection. (See information below). Please see standards 10 and 38 for more information and requirements about the environment. These explain how the home must improve the environment to meet people’s dignity and safety. Our findings from the random inspection we carried out on 3 October 2007: We spoke to people who live at the home, relatives and staff. All confirmed that the laundry could be a problem. This included missing clothes underwear and on occasions new clothes. Most people, and relatives, said they were not too concerned about it but would like to see it improve. One relative said they check their family members clothes regularly, they said staff were very helpful, however, some things were never found. There are a number of people at Galtee More who do not have regular visitors to check their clothing. Therefore they are more at risk of losing clothing. When we checked the laundry there was a pile and backlog of damp washing waiting to be dried. The member of staff who assisted me said one dryer had broken, and the remaining one was not sufficient to get through the drying in good time. This will not help to avoid people’s clothing going missing. Galtee More Nursing Home DS0000006480.V364081.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. People receive support from well-trained staff. Some people have concerns about the staffing levels. EVIDENCE: People told us they were happy with the way staff supported them. Relatives told us, “This is a caring, friendly home” “Sometimes the staffing levels make it hard for staff” “Staff understand my Mum, they treat her as an individual” Some relatives and staff raised concern that staffing levels are low. In the main this affected people’s opportunities to activities and social contact from staff. The manager told us because the home was not full she had reduced the staffing levels, but was confident people would get the correct nursing and personal care. (See standard 12 about recommendations we have carried forward about people’s access to activities). The manager confirmed that she would increase the staffing levels again once they had filled the vacant rooms. Galtee More Nursing Home DS0000006480.V364081.R01.S.doc Version 5.2 Page 21 Over 50 of staff have a National Vocational Qualification in care. This, as well as the homes good training systems gives people support from skilled staff. We saw that the manager has put in place good opportunities for staff to access training and guidance. For example, staff have in-house training for safeguarding vulnerable adults, the mental capacity act, and moving and handling. The manager has arranged this through Train-the-trainer courses. The manager also gives staff access to the Barnsley Metropolitan Borough Council social care training events. We checked the training matrix, this showed what training staff have done, and it identifies when they are due for up-date-training. It was evident the manager has made good progress with this. The last key inspection identified that the homes’ recruitment procedures were not safe. For example, some staff did not have the correct Criminal Bureau Record (CRB) Check. We checked two samples on this occasion, and the manager told us all staff now had full CRB checks. We checked a sample of staff recruitment records. These are in good order. It shows us the home follows the correct recruitment procedures in order to employ the right staff to give people safe nursing and personal care. Galtee More Nursing Home DS0000006480.V364081.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. People who use the service experience poor quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. People’s safety and welfare is at risk because the provider, manager and staff do not always follow sound health and safety practices, or take enough action to prevent risks. EVIDENCE: The manager is not yet registered with us. We have asked the manager and provider over the past two key inspections to arrange for the manager to apply for registration. At the time of this visit the manager had still not applied. The CSCI registration team will look into this. Galtee More Nursing Home DS0000006480.V364081.R01.S.doc Version 5.2 Page 23 We saw some evidence of good quality assurance systems, for example, staff training systems, information systems, and opportunities for people and their families to feedback their opinion about the home. However, other quality assurance checks did not protect people from harm, for example water checks and environmental safety checks (furniture in stairwell, unlocked sluices and hot water temperatures). We checked a sample of records held on behalf of people who wanted the home to keep their spending money safe. The records were in good order; they had withdrawals backed up with receipts, double signatures for deposits and withdrawals, and regular audits. We found some practices that do not protect people’s health, safety and wellbeing, for example: People do not have access to a bath or shower. The shower is not in use, a further bathroom is out of order and has been for sometime; and the hoists to the two remaining baths are out of order. Although the provider assured us he had taken action to get the hoists repaired, this has not happened in a timely manner. We noted that the provider had not maintained hoist maintenance contracts, and this had led to a delay in finding a suitable alternative contractor. As a result people could only have strip washes in their bedrooms. However, the water supply to people’s bedrooms is poor, and staff have to carry hot water, in wash-bowls, across corridors. Staff told us this is a lengthy procedure when people get up in a morning. On the previous key inspection we identified a bath tap that was unsafe because the temperature of the water was too high and put people at risk of scalds. The manager said they had repaired the tap. However, when we checked, the water was still hot enough to cause scalds. People are at risk in this situation, staffing levels mean that staff are busy with nursing and personal care tasks, the bathroom door is unlocked, if someone tries to run their own bath, or a staff does not check the temperature, someone could receive serious scalds. We informed the manager about this at the time. We found the sluice door open and it had a broken lock. This means unauthorised people could enter and put themselves and others at risk from contamination and poor hygiene incidents. Most bedrooms had old wooden commodes; some of these had varnish worn down to the bare wood. And some had worn seats leaving strands of material around the pan area. This does not promote good infection control. Galtee More Nursing Home DS0000006480.V364081.R01.S.doc Version 5.2 Page 24 The home did have some stored furniture under a stairwell, such as an organ and stool. However, the fire authority had recently visited the home made no requirements. The manager confirmed the items were under the stairwell at the time of the fire officer’s visit., and he raised no concerns. There was a high number of people who do not use footplates. The manager had consulted with people, or their families, and obtained their written consent not to use footplates. However, we feel that the home has not taken enough action to inform people about why this is dangerous practice, we found no evidence about how the home had informed and encouraged people, and their families to understand safe wheelchair use. Our findings from the random inspection we carried out on 3 October 2007: We noticed the hoist and stand aid were not available and ready for people who wanted to move. For example, if they wanted to go to the toilet or to bed. It took a member of staff a while to find the equipment. We also found one stand aid was out of order. There was only one hoist and one stand aid to cover both floors. This is not sufficient to make sure equipment is always available for people when they want to move. There were three communal hoist slings. This is not good practice for infection control. I advised the nurse on duty that people should have their own slings, including a spare. On our key inspection dated 10 April 2008, we found sufficient hoists and slings to meet people’s needs. People who live at the home and staff said the manager was supportive and fair. Galtee More Nursing Home DS0000006480.V364081.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 1 X 3 X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X X 1 Galtee More Nursing Home DS0000006480.V364081.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP10 Regulation 12.4(a) Requirement Staff practices must improve so that people live in an environment that respects their needs and dignity. Timescale for action 31/07/08 2. OP21 23.2(b)(j) For example: Put the continence pads out of sight Remove the slippers and shoes Remove communal toiletries and make sure people have their own personal items Remove commodes from rooms where people don’t need them Improve support at mealtimes. The provider must provide in 31/07/08 sufficient numbers baths and showers fitted with a hot and cold water supply This will enable people to live in a home fit for it’s purpose. The provider must provide laundry equipment that is in good working order and sufficient to manage the homes laundry. The provider must improve the homes quality assurance DS0000006480.V364081.R01.S.doc 3. OP26 23.2(c) 31/07/08 4. OP33 13.4(a) 31/07/08 Galtee More Nursing Home Version 5.2 Page 27 5. OP38 13.4 (a)(c) systems to include better health and safety checks so that people live in a safer environment. All water supplies to the home where people have access must be within safe temperature limits. And The home must check water temperatures regularly to make sure people are not at risk from scalds. Timescale carried forward from 16/04/2007. The home must improve it’s health and safety practices to make sure people are safe and protected from accidents For example: Lock the sluice door Replace damaged and worn commodes Put systems in place to encourage people to use wheelchairs safely Repair the tap that has a supply of hot water at a temperature that will scald Make sure hoists are maintained in good working order, and have systems in place for regular health and safety checks and repairs. 31/07/08 6. OP38 13.4(a)(c) 31/07/08 Galtee More Nursing Home DS0000006480.V364081.R01.S.doc Version 5.2 Page 28 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP33 Good Practice Recommendations The provider should carry out provider visit reports so that he can show evidence that the home is making progress in the best interests of the people who live there. The provider should have a development plan to prioritise the improvements they need to make. The home should review their social activities and make arrangements to enable people to participate in activities. The home should review the staffing compliment to make sure there is sufficient staff to help support people to participate in social activities. We have carried this recommendation forward from the last key inspection. People should receive one-to-one support at meal times. Kitchen staff should prepare people’s soft diets with the items of the meal softened and served separate on the plate. These practices will better will respects people’s rights to dignified mealtimes. The manager should consult with people and offer a more varied diet to those who would prefer it. The provider should take the necessary action to register a manager at the home. 2. OP12 3. OP15 4. OP31 Galtee More Nursing Home DS0000006480.V364081.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Galtee More Nursing Home DS0000006480.V364081.R01.S.doc Version 5.2 Page 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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